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High blood pressure, beta blockers and MDMA?

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stoned_baby

Bluelighter
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So ive done some research in the forums here on Bluelight as well as other web sites, and im still unable to find a good coherent answer to my question. It goes like this:

I recently got diagnosed with high blood pressure, and am now on a regimen of beta blockers (metoprolol). When diagnosed the doctors made an investigation of heart and lungs, took blood samples, etc, and all but the blood pressure seemed normal. I lead a healthy life, work out, eat well, etc. BUT, it would be nice to keep one of my bad habits, namely the occasional late night out, dancing to sweet electronic rythms and doing E (or occasionally some other stimulant).

Of course stims are generally discouraged when you suffer from high blood pressure. But, since ive probably had this condition for a long time before diagnosed (runs in the family) i figure that ive done it before and been OK (sometimes ive gotten headaches when partying too long).

SO my question is: IF i decide to go on a party binge this summer, what would be the safest way to go about it? Should i stop medicating in advance? Should i be on a beta blocker when i do the stim (probably MD)? The dodgiest part seem to be to get a straight answer about the medicine. Some sources tell me that beta blockers are highly contraindicated with stims since the combination can cause heart rhytm irregularities. Other sources indicate that they only do that with coke. Just to utterly confuse, other sources report that beta blockers are used in clinical settings to combat the strain of stimulant overdoses on the heart. I even found one report stating that beta blockers have been used to ease cocaine hypertension.

And there is ample anecdotal evidence of various stims combined with beta blockers to no detrimental effect. Still it would be nice to hear a solid medically educated opinion.

Hope this is in the right forum, feel free to move it if not.
 
I suffer from mild hypertension due to family history. I'm otherwise quite healthy and take atenolol another beta blocker. I have had the same concerns, I haven't taken with x yet but have with several other potent stimulants and have had no problem.

I also asked my pharmicist (I happen to have one that is open minded and confidientional) and he told me I had nothing to fear. That is, as long as my bp is controlled. You just must worry about the usual risks of stimulant use.
 
Thanks for your input! Sounds like we are in a similar situation.

As i recall Atenolol is also a selective beta blocker like metoprolol, so they operate the same way on the heart. Must feel great to have a pharmacist that you can talk to about these things. I dont dare bring it up with my doctor, and anyway im sure the advice i would get would be "DONT!!!". Which of course from her perspective is absolutely correct.

Did you notice any weird or unusal effects while doing the combo?
 
Not really. The only thing I notice different is that my heart rate seems to stay lower than it normally would on stimulants alone and I am assuming that to be a good thing.
 
hey stoned baby, great question!

first of all, how high does your blood pressure run? in general if your systolic is under 150 and your diastolic is under 90 (stage 1 hypertension) you should be fine, especially if you're treating it with metoprolol. if it normally runs higher than that (without treatment) i would really reconsider.

REALLY IMPORTANT: if you DO decide to drop, do NOT discontinue your metoprolol, your beta adrenergic receptors become highly sensitized after a while and if you stop taking metoprolol and drop you would be putting your heart in a lot of danger. so if you do decide to drop, make sure to take your metoprolol as well, and try not to go over 2-3 pills in a night!
 
Thanks doctorX, valuable advice!

I didnt post my bp before because im not sure they got it right. I have the "white coat syndrome", which makes me extra nervous at hospitals and when dealing with doctors in person. Silly i know, but what to do?

The doctor who took my BP registrered 160-95 i think. But i was feeling my heart beating like i hammer, clearly stressed out from the surroundings, as usual.

Last time i went to my doc after a month of treatment with 50 mg metoprolol she registrered 125 and (dont recall the diastolic value but it was lower).

So your opinion is that it is safer to keep taking the meds. I understand the logic behind that. They warn you from interrupting medication with beta blockers anyway, since it can cause a "rebound" effect if i understood it right, and you might feel hypertensive because of it. (I have gone days without though and not felt anything).

Maybe getting that rebound thing along with extra adrenergic stimulation from the stim at the same time might be more worth taking into account than the other - more hypothetically sounding - risk of getting heart rhytm irregularities? I dont know actually if that is a documented phenomena or just a theory.
 
stoned_baby said:
Thanks doctorX, valuable advice!

I didnt post my bp before because im not sure they got it right. I have the "white coat syndrome", which makes me extra nervous at hospitals and when dealing with doctors in person. Silly i know, but what to do?

The doctor who took my BP registrered 160-95 i think. But i was feeling my heart beating like i hammer, clearly stressed out from the surroundings, as usual.

Last time i went to my doc after a month of treatment with 50 mg metoprolol she registrered 125 and (dont recall the diastolic value but it was lower).

So your opinion is that it is safer to keep taking the meds. I understand the logic behind that. They warn you from interrupting medication with beta blockers anyway, since it can cause a "rebound" effect if i understood it right, and you might feel hypertensive because of it. (I have gone days without though and not felt anything).

Maybe getting that rebound thing along with extra adrenergic stimulation from the stim at the same time might be more worth taking into account than the other - more hypothetically sounding - risk of getting heart rhytm irregularities? I dont know actually if that is a documented phenomena or just a theory.
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Hey again stoned baby,

it's my pleasure! now, having said that, i'm not supposed to be giving you medical advice because even though I am a medical professional, this is the internet and I could be some sick person trying to mess you up. so please bare that in mind!

having said that, the white coat syndrome is totally normal, and happens to most hypertensive patients because no one wants to have high blood pressure and you obviously worry about the possible consequences of such diagnosis. anyway, 160/95 is in the area called "second stage hypertension," you can look up more information on that if you wish. in your situation, it is my honest opinion that MDMA is just not the drug for you.

if you INSIST on using it (and youre not a horrible person for doing that because E is a lot of fun), please do not discontinue your metoprolol. you're absolutely correct about the rebound effect and it's what i tried to address in my first response to you. the heart rhythm irregularities that you are referring to may occur because your body's normal adrenergic response to MDMA (norepi and epi release) will be competing with the metoprolol for beta receptors and so the risk of irregularities IS real. but if I HAD TO CHOOSE rebound Vs irregularities, i'd take the irregularities, although again, those could be potentially risky.

in summary: there are certain inherent risks that everyone takes when they drop and the risks that you would be taking are substantially higher. if you do decide to take that risk please be extra safe, pay attention to your body, dont take more than you can handle and don't be afraid to seek medical care if you do feel like something is going wrong.
 
Thanks again for your candid advice man! I looked up the different stages of hypertension too in my investigation, and if those first bp numbers i got are anything to go by im in a pretty bad shape. But i sort of have a feeling that they would be substansially lower if i could read them at home or in less stresfull surrondings. Or am i wrong?

Of course a dance party will be packed with stressors to get the adrenaline flowing. Thats what we like about it. But my impression is that we dont have to worry that much about short spikes. Its if the baseline gets elevated for really long that the strain starts to show on organs and veins, right?

As i believe you have guessed i will probably get myself some good parties this summer, bp or no bp (i have earned it :)). So the question for me is how to go about this the safest way possible. Your answer goes a long way actually. Thanks again!

Also if anyone has any tips on posible preloads or postloads... I take several vitamins, fishoil, q10.
 
hey stoned baby (love that name),

my suggestion would be to ask your doctor for a 24 hour BP monitor, it's a comfortable blood pressure cuff that records BP every hour, including when you sleep and this way you can get an average 24 hour blood pressure reading. this is much more important than spikes (you're absolute right about that). getting that average will let you know where you stand with your hypertension.

as far as partying, just have fun! if you think about it you may freak yourself out and have a terrible roll, and raise your BP just with all that added stress, which you seem to be sensitive to in the first place! One thing is, just once every hour or so check up on yourself, stop for a second and see if you're light headed, or have a severe headache or other things that you normally wouldn't expect from E.

a good preload for you would be Ginkgo Biloba, you can find that at a local drug store. the reason for this preload is because Gingko shows vasodilatory properties, especially to the cerebral cortex, which would do you a lot of good because that will decrease your risk of stroke and heart attack. afterload, some good cali weed!

cheers, be safe and more importantly, HAVE FUN!
 
What dose of Toprol are you on? and is the the ER (Extended Release). I take 50mg once daily Toprol ER (The generic eqiuv) and I have always wondered what issues it could cause. I personally keep track of my BP daily with my own monitor, so I always keep track of my own vitals when I experiment with anything also.
 
Man, i love a doctor that prescribes weed as a post-load =D! They sure wouldnt do that over here!

Yeah i also thought about getting one of them things to measure bp at home, just out of curiosity. Because if it really was as high as the first reading i got id want to do some MAJOR lifestyle changes. Totally drop coffe and tobacco to begin with.

I also see a freak out as the main concern, more so than the risk of heart arrythmias. The old self-fulfilling worry thing. But on the other hand, ive done stimulants so many times, and they normally make me calm (MDMA definitely), so i would be silly to freak out this time. Ill start low (as usual) and go incremental. Its good to know that i can keep my medicine. I hate worrying about potential medical wire-crossings.

The last time i did speed i ended up with a terrible headache around 4 in the afternoon. In retrospect i believe my bp has done that to me various times. If i drag out a party too long (sometime in the afternoon next day i usually start to fold) i almost invariably end up with a headache, ranging from mild to pretty severe.

Ill try the Ginko too, been eyeing that anyway for a long time now (its damn expensive over here!). Thanks again for the good advice!
 
Tomwin: Im on metoprolol 50mg, and its the extended release. As i understand it its the lowest dosage of metoprolol.

When you experiment with drugs, is it always in your own house? If not, isnt it a bit complicated to take your vitals in club/party settings?
 
stoned_baby said:
Tomwin: Im on metoprolol 50mg, and its the extended release. As i understand it its the lowest dosage of metoprolol.

When you experiment with drugs, is it always in your own house? If not, isnt it a bit complicated to take your vitals in club/party settings?
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If I am truly experimenting, as in never taken before, then yes. I do that in my own home, and keep tabs on things like blood pressure.

If you are on Dr. prescribed meds for blood pressure then you really should own a blood pressure monitor anyway. They are very portable, and it probably wouldn't be a bad idea to know what your BP is when you are rolling anyway. Just throw the BP monitor in the car. I always have a reason to go back to the car at least once :)
 
^ alc only seems to make my blood pressure go up. I just try to relax, pot helps me a bit. There are some very good breathing exercises you can look-up that really help with blood pressure (there's also other fast acting meds that can help, but I'm not recommending mixing anything else into the equation).

I just feel it's a good idea to know how stressed your system may or may not be under those circumstances for your own knowledge and decision making.
 
Yeah it seems alcohol gives one a raise in bp, checked it out. Damn, another thing ill have to go easy on!

With "other fast acting meds" you refer to benzodiazepines? Of course it would be best to not drop more stuff into the mix. But maybe could be a good idea to keep them around for emergencies..?

Checked out Ginko Biloba, and its contraindicated with MAOIs and SSRIs according to wikipedia. So it might be a bad idea to mix with serotonergic drugs, right?
 
Further thoughts on the matter:

If the theory of beta blockers vs stimulant drugs is taken seriously, shouldnt it be contraindicated with coffe, as well as with all the various stimulants that doctors prescribe these days? No mention of the matter in the metoprolol folder. I even read anecdotal reports on beta blockers being prescribed along with ADHD meds of the stimulant kind.

Its weird that there is so much confusion on this, as beta blockers are such a frequently used medication. (Stimulants too for sure).

(Maybe this thread sits better in another forum on second thought?)
 
I think you're not getting the answer you want because nobody really knows. MDMA isn't exactly an exhaustedly researched drug to begin with, and there isn't really a market for testing schedule 1 stimulants on people with high blood pressure.

I proposed the same question in this forum a while ago (about atenolol though), reading all of the same stuff you read. There is a lot of conflicting information, and it's really really annoying and confusing. I wasn't looking for "It's 100% okay to roll!" I know it's a dumb idea. I just wanted to know HOW dumb it was.

My honest conclusion is: you are probably not going to drop dead, stroke out, have a heart attack, *insert horrible scenerio here* if you decide to take a pill or two one night. However, the more often you take these pills, the higher your blood pressure goes, and the more damage you do to your vital organs and circulatory system. That makes it more likely that you will meet with that horrible scenerio sooner or later. So I guess this all depends on what your definition of "binge" is.
 
trip:

Ive read your threads on the same subject, and found useful information in them. Did you go ahead and roll BTW?

Sure, MDMA is a controlled substance, and probably underresearched with regards to interactions. But the substance has been in use for a long time now. Surely there must be some empirical conclusions we can begin to draw? I would hope that if there was a clear contraindication it would have showed up by now.

And then there is the whole field of other stimulants - some of them legal, some of them, from what i understand, even prescribed along with beta blockers. There must be some kind of medical justification for docs to do that. If not just stupidity.

I guess i, like you, get frustrated by the conflicting information. If one source says "hell no!", and the next source says "could even be a good idea!", youre kind of left on your own. I got some good replies in this thread, but no harm in trying to penetrate deeper into the issue :)

As for my own use, its pretty soft core. I doubt i would go over 2 good pills regardless, and i would definitely be more wary now about amping up with other stims than ive been in the past.
 
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